Laminoplasty Hinges

ABSTRACT

A surgical implant device configured to adjust in planar orientation or angular orientation or both to correspond to the structure of the lamina to be spanned at the site of a cut of the laminoplasty surgery. The device includes a base having slots extending adjacent thereto, and an extension having a head configured to be adjustably positionable within the slots.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims priority to U.S. Provisional Application No.62/558,957 filed Sep. 15, 2017, entitled LAMINOPLASTY HINGES,incorporated herein by reference in its entirety.

FIELD

This disclosure relates to the field of laminoplasty surgery. Moreparticularly, this disclosure relates to hinge structures and the usethereof in laminoplasty surgery.

BACKGROUND

Improvement is desired in devices for use in laminoplasty surgery.Laminoplasty is a spine surgery procedure in which the lamina at theposterior of the spine is removed. One type of laminoplasty referred toas Open Door Laminoplasty involves making two cuts to relieve pressureon the spine. One cut is made completely through one side of thevertebrae between the lamina and lateral mass. A second partial cut ismade on the opposite lateral side. The lamina is hinged about thepartial cut. Implant devices are often affixed to the spine at thelocations of the cuts to provide support.

The present disclosure relates to improved devices for use inlaminoplasty procedures, and particularly for use with open doorlaminoplasty procedures. The devices are advantageously configured to beable to adjust in planar orientation or angular orientation or both.This advantageously enables a reduction in the inventory of device sizesand enables the device to be adjusted in size. The ability to adjust theangular orientation of the device enables the device to be oriented tolie flush with on the lamina without having to bend the material of thedevice as is done conventionally.

SUMMARY

The above and other needs are met by surgical implant devices. Theimplant devices are desirably configured for use at complete cut andpartial cut locations of an open door laminoplasty surgical site.

The surgical implant devices are configured to be adjustable in size andorientation so as to be adaptable to a surgical site.

In one aspect, a surgical implant device according to the disclosureincludes a base and an extension adjustably connectable to the base toenable adjustment of both planar and angular orientations of thesurgical implant device. The base has a seat and a back extending fromthe seat.

The extension has an elongated body with a head at an end of theelongated body of the extension, the head having oppositely extendingarms. The head of the elongated body of the extension is positionablebetween the slots of the base so that the arms of the head of theelongated body span between the slots of the back of the base,

When the head of the extension is positioned between the slots of thebase when the implant device is installed in a patient during surgery,the head of the extension is freely pivotable within the slots of thebase to permit a plurality of angular orientations of the implantdevice. Also, the head is movable along the elongate length of the slotsto provide adjustment of the planar orientation of the implant devicebased on the location of the head along the elongate length of theslots.

In another aspect, there is provided a surgical implant device surgicalimplant configured to be adjustable in size and orientation so as to beadaptable to a surgical site. The implant device includes a base and anextension adjustably connectable to the base to enable adjustment ofboth planar and angular orientation of the surgical implant device.

The base has a seat and a back extending from the seat. The extensionhas an elongated body with a head at an end of the elongated body of theextension. The head is pivotally mountable or movably mountable or bothto the extension to permit a plurality of different configurations ofthe implant device.

In a further aspect, there is provided a surgical implant deviceconfigured for use at the complete cut location of an open doorlaminoplasty surgical site to span between a lamina of a vertebrae andan open mass of a vertebrae, the implant device configured to beadjustable in size and orientation so as to be adaptable to the opendoor laminoplasty surgical site at the time of surgery.

The implant device includes a base and an extension adjustably connectedto the base to enable adjustment of planar orientation or angularorientation or both of the surgical implant device.

The base has a seat and a back extending from the seat in a reclinedrelationship, a pair of spaced apart and aligned elongate slots locatedat a distal end of the back of the base, a hook configured to be able tohook onto the lamina of the vertebrae and a foot configured to be ableto buttress against the lateral mass of the vertebrae.

The extension has an elongated body with a head at an end of theelongated body of the extension. The head has oppositely extending arms.The head of the elongated body of the extension is positionable betweenthe slots of the base so that the arms of the head of the elongated bodyspan between the slots of the back of the base.

When the head of the extension is positioned between the slots of thebase when the implant device is installed in a patient during surgery,the head of the extension is freely pivotable within the slots of thebase to permit a plurality of angular orientations of the implant deviceand the head is movable along the elongate length of the slots toprovide adjustable planar orientation of the implant device based on thelocation of the head along the elongate length of the slots.

BRIEF DESCRIPTION OF THE DRAWINGS

Further advantages of the disclosure are apparent by reference to thedetailed description when considered in conjunction with the figures,which are not to scale so as to more clearly show the details, whereinlike reference numbers indicate like elements throughout the severalviews, and wherein:

FIGS. 1-3 depict use of devices according to the disclosure as used foran open door laminoplasty procedure.

FIGS. 4-6 show the structure of one of the devices of FIGS. 1-3 designedfor use at the location of a complete cut of the laminoplasty procedure.

FIGS. 7-9 show one of the device of FIGS. 1-3 designed for use at thelocation of a partial cut of the laminoplasty procedure.

FIGS. 10-12 show an alternate embodiment of a device according thedisclosure and designed for use at the location of a partial cut of thelaminoplasty procedure.

FIGS. 13-16 show an alternate embodiment of a device according thedisclosure and designed for use at the location of a full cut of thelaminoplasty procedure.

FIGS. 17-19 show an additional embodiment of a device according thedisclosure and designed for use at the location of a full cut of thelaminoplasty procedure.

DETAILED DESCRIPTION

With initial reference to FIGS. 1-3, there is shown a device 10 and adevice 12 as used for an open door laminoplasty procedure. The devices10 and 12 are desirably configured to be adjustable in size andorientation so that they may be adapted to the site at the time ofsurgery.

In the open door laminoplasty procedure depicted, a cut 14 has been madecompletely through one side of a vertebrae 16 between a lamina 18 and alateral mass 20 of the vertebrae 16. The device 10 spans the cut 14.

FIGS. 1 and 2 show the device 10 installed at the site of the cut 14 andfixed in place with fasteners. As seen, the device 10 is able to adjustin planar orientation or angular orientation or both to correspond tothe structure of the lamina to be spanned at the site of the cut 14.

A second partial cut 22 has been made on the opposite lateral side, andthe lamina 18 is hinged about the partial cut 22. The device 12 spansthe cut 22.

FIGS. 1 and 3 show the device 12 installed at the site of the partialcut 22 and fixed in place with fasteners. As seen, the device 12 is ableto adjust in planar orientation or angular orientation or both tocorrespond to the structure of the lamina to be spanned at the site ofthe cut 22.

Each of the devices 10 and 12 is advantageously configured to be able toadjust in planar orientation or angular orientation or both. The abilityof the devices to adjust in its planar orientations, such as by being ofadjustable planar orientation or angular orientation or both, enablesthe devices to be able to be provided in a variety of differentconfigurations. This advantageously enables a reduction in the inventoryof devices.

The ability to adjust the plan orientation enables the device to beadjusted to a variety of surgical sites. The ability to adjust theangular orientation of the device enables the device to be oriented tolie flush with on the lamina without having to bend the material of thedevice as is done conventionally. The devices 10 and 12 are of hingedconstruction and adjustable planar construction.

With additional reference to FIGS. 4-6, the device 10 includes a base 30and an extension 32 hingedly and adjustably connected to the base 30 ina manner that enables adjustment of both the planar and the angularorientation of the device 10. As depicted, apertures are provided on thebase 30 and the extension 32 for passage of fasteners to fasten the baseand the extension 32 to the lamina.

The base 30 includes a seat 30 a and a back 30 b extending from the seat30 a in a reclined relationship, preferably at an angle of from about 30to about 75 degrees, most preferably about 45 degrees. A pair of spacedapart and aligned slots 30 c are located at the distal or free end ofthe back 30 b.

The extension 32 is T-shaped and includes an elongated body 32 a havinga head 32 b at an end of the body 32 a, with the head 32 b havingoppositely extending arms of uniform length. The device 10 is assembledby placing the head 32 b of the extension 32 to span between the slots30 c of the back 30 b of the base 30. As depicted in FIG. 4, the head 32b is at a lowermost end of the slots 30 c, and in FIG. 5 the head 32 bis at an uppermost end of the slots 30 c. These views depict the rangeof planar adjustment. In addition, FIGS. 4 and 5 depict differentangular orientations of the head 32 b relative to the extension 32, itbeing understood that the head 32 b may freely pivot within the slots 30c to permit various relative angular orientations.

In this regard, the term slots as used herein will be understood torefer to the oval or elongate slots shown in the drawings and will beunderstood to encompass other elongate geometries or structures that canprovide a constrained path for travel of the head of the extension thatenables the head to pivot and to change position for adjustment of theplanar orientation or the angular orientation or both of the implantdevice. Also, it will be appreciated that the base may be constructedwith only a single slot or structure in which the head may engage and bepivotally and movably positionable relative to the base.

With additional reference to FIGS. 7-9, the device 12 includes a base 40and an extension 42 adjustably connected to the base 40 in a manner thatenables adjustment of both the planar or the angular orientation or bothof the device 12. Apertures are provided on the base 40 and theextension 42 for passage of fasteners.

The base 40 includes a seat 40 a and a pair of spaced apart and alignedovals or slots 40 b extending from the seat 40 a.

The extension 42 is T-shaped and includes an elongated body 42 a havinga head 42 b at an end of the body 42 a with oppositely extending arms ofuniform length. A bend 42 c is provided between the body 42 a and thehead 42 b. The bend 42 c preferably disposes the head 42 b at an anglerelative to the body 42 a, the angle being from about 10 to about 60degrees, most preferably about 40 degrees.

The device 12 is assembled by placing the head 42 b of the extension 42to span between the slots 40 b of the base 40. As depicted in FIG. 8,the head 42 b is at a lowermost end of the slots 40 b, and in FIG. 7 thehead 42 b is at an uppermost end of the slots 40 b. These views depictthe range of planar adjustment, in this case, length adjustment. Inaddition, FIGS. 7 and 8 depict different angular orientations of thehead 42 b relative to the extension 42, it being understood that thehead 42 b may freely pivot within the slots 40 b to permit variousrelative angular orientations.

FIGS. 10-12 show an alternate embodiment of a device 50 according thedisclosure and designed for use at the location of a partial cut of thelaminoplasty procedure. The device 50 is similar to the device 12 andincludes a base 60 and an extension 62 adjustably connected to the base60 in a manner that enables adjustment of both the planar and theangular orientation of the device 50. However, the device 50 isadvantageously constructed to resist undesired separation of theextension 62 from the base 60. Apertures are provided on the base 60 andthe extension 62 for passage of fasteners.

The base 60 includes a seat 60 a and a pair of spaced apart and alignedovals or slots 60 b and 60 c extending from the seat 60 a. A gap isdefined by the spacing of the slots 60 a and 60 b. The slot 60 bincludes an indent 60 d at the interior lower edge thereof. The slot 60c includes an enlarged interior lower edge thereof that provides a stop60 e that is opposite of the indent 60 d and extends towards the indent60 d.

The extension 62 is T-shaped and includes an elongated body 62 a havinga head 62 b at an end of the body 62 a. A neck 62 c is provided betweenthe body 62 a and the head 62 b. The head 62 b includes a pair ofoppositely extending arms 62 d and 62 e. The arm 62 d is longer than thearm 62 e. As explained more fully below, the arms 62 d and 62 ecooperate with the indent 60 d and the stop 60 e to resist undesiredseparation of the extension 62 from the base 60.

Similar to that described for the device 12, it will be appreciated thatthe structure of the device 50 enables different angular orientations ofthe head 62 b relative to the extension 62, it being understood that thehead 62 b may freely pivot within the slots 60 b and 60 c to permitvarious relative angular orientations.

With reference to FIG. 12, the device 50 is assembled by placing thehead 62 b of the extension 62 to span between the slots 60 b and 60 c ofthe base 60. The head 62 b is inserted into a lowermost end of the slots60 b and 60C, with the shorter arm 62 d inserted via the space providedby the indent 60 d. The longer arm 62 d of the head 62 b is slid intothe space of the indent 62 d and the shorter arm 62 e is located behindthe stop 60 e to complete installation. Thus, to remove the extension 62from the base 60, one has to reverse the insertion process, which takesspecific manipulation of the arms 62 d and 62 e relative to the indent60 d and the stop 60 e. These manipulations are unlikely to occur oncethe implant 50 is installed in a patient. Thus, it will be appreciatedthat the arms 62 d and 62 e cooperate with the indent 60 d and the stop60 e to resist undesired separation of the extension 62 from the base60.

FIGS. 13-16 show an alternate embodiment of a device 70 according thedisclosure and designed for use at the location of a full cut of thelaminoplasty procedure.

The device 70 is similar to the device 10 and includes a base 80 and anextension 82 adjustably connected to the base 80 in a manner thatenables adjustment of both the planar and the angular orientation of thedevice 70. However, the device 70 is advantageously constructed toresist undesired separation of the extension 82 from the base 80 and toenable a desired placement of bone screws. Apertures are provided on thebase 80 and the extension 82 for passage of fasteners.

The base 80 includes a seat 80 a and a pair of spaced apart and alignedovals or slots 80 b and 80 c extending from the seat 80 a. A gap isdefined by the spacing of the slots 80 a and 80 b. The slot 80 bincludes an indent 80 d at the interior lower edge thereof. The slot 80c includes an enlarged interior lower edge thereof that provides a stop80 e that is opposite of the indent 80 d and extends towards the indent80 d.

As shown in FIG. 14, the seat 80 a is also advantageously configured tominimize the width dimension, noted by arrows W, and the planardimension, in this case length dimension, noted by the arrows L,representing the length of the seat 80 a that is seated on the spine,which is from a bend 80 f to a distal end of the seat 80. Thisconfiguration of the seat 80 a provides concave indents 80 g thatprovide locations to enable fasteners in the nature of bone screws, suchas a pedicle screw PS or lateral mass screw or the like to be placedimmediately adjacent the base 80 a.

The extension 82 is T-shaped and includes an elongated body 82 a havinga head 82 b at an end of the body 82 a. A neck 82 c is provided betweenthe body 82 a and the head 82 b. The head 82 b includes a pair ofoppositely extending arms 82 d and 82 e. The arm 82 d is longer than thearm 82 e. The arms 82 d and 82 e cooperate with the indent 80 d and thestop 80 e to resist undesired separation of the extension 82 from thebase 80.

Similar to that described for the device 10, it will be appreciated thatthe structure of the device 70 enables different angular orientations ofthe head 82 b relative to the extension 82, it being understood that thehead 82 b may freely pivot within the slots 80 b and 80 c to permitvarious relative angular orientations.

With reference to FIG. 16, the device 70 is assembled by placing thehead 82 b of the extension 82 to span between the slots 80 b and 80 c ofthe base 80. The head 82 b is inserted into a lowermost end of the slots80 b and 80C. The longer arm 82 d of the head 82 b is slid into thespace of the indent 82 d and the shorter arm 82 e is located behind thestop 80 e to complete installation. Thus, to remove the extension 82from the base 80, one has to reverse the insertion process, which takesspecific manipulation of the arms 82 d and 82 e relative to the indent80 d and the stop 80 e. These manipulations are unlikely to occur oncethe implant 70 is installed in a patient. Thus, it will be appreciatedthat the arms 82 d and 82 e cooperate with the indent 80 d and the stop80 e to resist undesired separation of the extension 82 from the base80.

FIGS. 17-19 show an additional embodiment of a device 90 according thedisclosure and designed for use at the location of a full cut of thelaminoplasty procedure.

The device 90 is similar to the device 70 and includes a base 100 and anextension 102 adjustably connected to the base 100 in a manner thatenables adjustment of the planar orientation or the angular orientationor both of the device 90.

As in the case of the device 70, the device 90 is advantageouslyconstructed to resist undesired separation of the extension 102 from thebase 100 and to enable a desired placement of bone screws. Apertures areprovided on the base 100 and the extension 102 for passage of fasteners.

The base 100 includes a seat 100 a and a pair of spaced apart andaligned ovals or slots 100 b and 100 c extending from the seat 100 a. Agap is defined by the spacing of the slots 100 a and 100 b. The slot 100b includes an indent 100 d at the interior lower edge thereof. The slot100 c includes an enlarged interior lower edge thereof that provides astop 100 e that is opposite of the indent 100 d and extends towards theindent 100 d.

Additional features of the base 100 include a hook 100 f and a foot 100g integrally formed therewith. As shown in FIG. 19, the hook 100 fenables the base 100 to engage and hook to the lamina 18 of thevertebrae 16, and the foot 100 g buttresses against the lateral mass 20of the vertebrae 16.

The extension 102 is T-shaped and includes an elongated body 102 ahaving a head 102 b at an end of the body 102 a. A neck 102 c isprovided between the body 102 a and the head 102 b. The head 102 bincludes a pair of oppositely extending arms 102 d and 102 e. The arm102 d is longer than the arm 102 e. The arms 102 d and 102 e cooperatewith the indent 100 d and the stop 100 e to resist undesired separationof the extension 102 from the base 100.

As in the case of the device 70, the device 90 enables different angularorientations of the head 102 b relative to the extension 102, it beingunderstood that the head 102 b may freely pivot within the slots 100 band 100 c to permit various relative angular orientations. In additionto the benefits of this previously described, this angular adjustabilityfeature in combination with the additional hook 100 f and 100 gstructures of the base 100 advantageously enables the device 90 toaccommodate a variety of lamina thicknesses. In this regard, once thedevice 90 is installed onto the vertebrae, the ability of the extension102 to pivot enables the device 90 to contour to the lamina regardlessof the thickness of the lamina 20 or the angle to be spanned.

The foregoing description of preferred embodiments for this disclosurehas been presented for purposes of illustration and description. It isnot intended to be exhaustive or to limit the disclosure to the preciseform disclosed. Obvious modifications or variations are possible inlight of the above teachings. The embodiments are chosen and describedin an effort to provide the best illustrations of the principles of thedisclosure and its practical application, and to thereby enable one ofordinary skill in the art to utilize the disclosure in variousembodiments and with various modifications as are suited to theparticular use contemplated. All such modifications and variations arewithin the scope of the disclosure.

1. A surgical implant device configured to be adjustable in size andorientation so as to be adaptable to a surgical site, the implantdevice, comprising: a base and an extension adjustably connectable tothe base to enable adjustment of both planar and angular orientations ofthe surgical implant device, the base having a seat and a back extendingfrom the seat, and a pair of spaced apart and aligned elongate slotslocated at a distal end of the back of the base, and the extensionhaving an elongated body with a head at an end of the elongated body ofthe extension, the head having oppositely extending arms, the head ofthe elongated body of the extension being positionable between the slotsof the base so that the arms of the head of the elongated body spanbetween the slots of the back of the base, wherein when the head of theextension is positioned between the slots of the base when the implantdevice is installed in a patient during surgery, the head of theextension is freely pivotable within the slots of the base to permit aplurality of angular orientations of the implant device and the head ismovable along the elongate length of the slots to provide adjustableplanar orientation of the implant device based on the location of thehead along the elongate length of the slots.
 2. The device of claim 1,wherein the device is configured for use at complete cut or a partialcut location of an open door laminoplasty surgical site.
 3. The deviceof claim 1, wherein the base includes a pair of spaced apart and alignedelongate slots.
 4. The device of claim 3, wherein one of the oppositelyextending arms of the head of the extension is longer than the other oneof the arms.
 5. The device of claim 4, wherein one of the slots of thebase defines an indent and one of the slots defines a stop opposite theindent, wherein when the extension is connected to the base, the longerone of the arms of the head of the extension is positioned within theslot having the indent and the shorter arm of the head is positionedwithin the slot having the stop and the arms cooperate with the indentand the stop to resist separation of the extension from the base.
 6. Thedevice of claim 1, wherein the seat of the base is configured tominimize a width dimension of the base and a length dimension of thebase, the seat shaped to define concave indents along opposite sidesthereof, the concave indents defining locations along the sides of theseat to enable bone screws to be placed immediately adjacent to the seatof the base.
 7. The device of claim 1, wherein the base further includesa hook and a foot integrally formed therewith and extending from spacedapart locations of a lower surface of the base.
 8. A surgical implantdevice configured to be adjustable in size and orientation so as to beadaptable to a surgical site, the implant device, comprising: a base andan extension adjustably connectable to the base to enable adjustment ofboth planar and angular orientation of the surgical implant device; thebase having a seat and a back extending from the seat; and the extensionhaving an elongated body with a head at an end of the elongated body ofthe extension, the head being pivotally or movably mountable or both tothe extension to permit a plurality of different configurations of theimplant device.
 9. The device of claim 8, wherein the back of the baseincludes an elongate slot and the head is positionable within theelongate slot to pivotally and movably mount the head to the base. 10.The device of claim 8, wherein the base includes a pair of spaced apartand aligned elongate slots located at a distal end of the back of thebase and the head includes oppositely extending arms each positionablein one of the elongate slots of the base to pivotally and movably mountthe head to the base.
 11. The device of claim 8, wherein the seat of thebase is configured to minimize a width dimension of the base and alength dimension of the base, the seat shaped to define concave indentsalong opposite sides thereof, the concave indents defining locationsalong the sides of the seat to enable bone screws to be placedimmediately adjacent to the seat of the base.
 12. The device of claim 8,wherein the base further includes a hook and a foot integrally formedtherewith and extending from spaced apart locations of a lower surfaceof the base.
 13. The device of claim 8, wherein the differentconfigurations of the surgical implant device comprise different planaror angular orientations or both of the surgical implant device.
 14. Asurgical implant device configured for use at complete cut location ofan open door laminoplasty surgical site to span between a lamina of avertebrae and an open mass of a vertebrae, the implant device configuredto be adjustable in size and orientation so as to be adaptable to theopen door laminoplasty surgical site at the time of surgery, the implantdevice, comprising: a base and an extension adjustably connected to thebase to enable adjustment of planar orientation or angular orientationor both of the surgical implant device, the base having a seat and aback extending from the seat in a reclined relationship, a pair ofspaced apart and aligned elongate slots located at a distal end of theback of the base, a hook configured to be able to hook onto the laminaof the vertebrae and a foot configured to be able to be able to buttressagainst the lateral mass of the vertebrae, and the extension having anelongated body with a head at an end of the elongated body of theextension, the head having oppositely extending arms, the head of theelongated body of the extension being positionable between the slots ofthe base so that the arms of the head of the elongated body span betweenthe slots of the back of the base, wherein when the head of theextension is positioned between the slots of the base when the implantdevice is installed in a patient during surgery, the head of theextension is freely pivotable within the slots of the base to permit aplurality of angular orientations of the implant device and the head ismovable along the elongate length of the slots to provide adjustment ofthe planar orientation of the implant device based on the location ofthe head along the elongate length of the slots.